ObjectivesThis study conducted a systematic review of published randomized controlled trials (RCTs) to evaluate the efficacy of acceptance and commitment therapy (ACT) for adolescent depression, while also examining its pertinent characteristics.MethodsWe conducted systematic searches of electronic databases in accordance with PRISMA guidelines to ensure rigorous screening, data extraction, and quality assessment. Additionally, we employed random-effects models and performed subgroup analyses.ResultsA meta-analysis of 25 studies with 2,352 participants showed that ACT significantly reduced depressive symptoms in adolescents. Improvements in psychological flexibility significantly predicted reductions in depression. Subgroup analysis revealed that, at post-test, ACT was significantly more effective than wait-list controls in reducing depressive symptoms, though it was not superior to Treatment As Usual or active treatment groups. Furthermore, offline ACT was significantly more effective than Internet-based ACT in reducing depressive symptoms. Comparisons of intervention settings also indicated that ACT was more effective in group settings than individual ones. However, no significant difference was found between clinical and non-clinical samples.ConclusionsThe current study suggests that ACT effectively reduces depressive symptoms, with psychological flexibility playing a crucial role in this improvement. Intervention forms and sample types should be considered when implementing ACT interventions. Extensive research is still needed for further exploration.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42023494677, identifier CRD42023494677.

This study primarily describes the four key characteristics and challenges in the current diagnosis of mental disorders: 1. Individual Differences in Symptoms of Mental Disorders; 2. Complexity of Factors Influencing Mental Disorders; 3. Psychopathology is a Broad and Continuous Spectrum; 4. Purely Data-Driven Psychiatric Diagnosis Requires Further Exploration. We aim to raise awareness of the importance of precise diagnosis and treatment in psychiatry. Additionally, through the description of the current challenges, we call for the standardization of future research to provide potential for data-driven medical diagnoses, ultimately promoting the precision, accessibility, and equity of healthcare resources.

Background: This longitudinal study assessed the prospective link between childhood maltreatment and sleep quality in adulthood, with a specific focus on examining whether different coping style tendencies influence these associations. Methods: The baseline sample included 1600 adult participants, with 1140 participants successfully followed up 5 years later. The key variables were measured using the Childhood Trauma Questionnaire (CTQ), Simplified Coping Style Questionnaire (SCSQ), and Pittsburgh Sleep Quality Index (PSQI). Generalized linear mixed models were employed to estimate unstandardized beta estimates and 95 % confidence intervals (95%CIs). Structural equation modeling was used to test the mediation model. Results: Individuals reported childhood maltreatment at baseline were at an increased risk for sleep disturbances at follow-up. Childhood maltreatment negatively predicted the baseline coping style tendency (beta = -0.29, P < 0.001), the baseline coping style tendencies negatively predicted the follow-up sleep quality (beta = -0.10, P < 0.001), and childhood maltreatment positively predicted the follow-up sleep quality (beta = 0.42, P < 0.01). The mediating effect of baseline coping style tendencies between childhood maltreatment and the follow-up sleep quality was significant, with an effect value of 0.03. Limitations: First, the sample was from a single province (Shandong), which limits the generalizability of the findings. Second, recall bias was unavoidable in this adult sample study. Conclusions: Developing positive coping strategies is an important way to reduce the risk of sleep problems in adults with a history of childhood maltreatment.

ObjectiveCognitive impairment represents a notable feature of depressive disorders. Comprehending its characteristics and influencing factors is vital for patient rehabilitation.MethodsThis study is based on the 2015 Shandong Province epidemiological survey of mental disorders, from which 871 individuals meeting DSM-IV criteria for depressive disorders were selected as the research group. Using 1:1:1 matching by sex, age, and residence, we randomly selected 825 individuals with no DSM-IV diagnosis but positive on GHQ-12 and additional risk assessments as the elevated risk control group, and 825 with negative screenings as the minimal risk control group. In 2020, a follow-up survey was conducted, resulting in a final analysis of 1,855 cases. The survey included demographic data, various clinical information, and a series of screening and questionnaire assessments.ResultsThe current depressive group scored lower on the MoCA than the non-depressive group (t=8.86, P<0.01). The research group scored lower on the MoCA than the elevated and minimal risk group (F=11.98, P<0.01). The depression-unremitted group scored lower than the depression-remitted group (t=6.44, P<0.01). The Analysis indicated that males, with better life quality, poor early psychological status and, and longer education were associated with higher MoCA scores. Conversely, older age, rural residency, employment, current depression, and poor marital were associated with lower MoCA scores.ConclusionIndividuals with depression commonly suffer cognitive impairment, which tends to partially improve as depression remits. Individual cognitive function is influenced by early psychological health, depressive status, quality of life, age, sex, educational level, residence, occupational, and marital status.

Background: This study extends from the 2015 Shandong Province Epidemiological Survey of Mental Disorders in adults aged 18 and above. Over five years, it investigates pain characteristics and influencing factors in individuals with depressive disorders in Shandong Province. Methods: The study encompasses 871 individuals who met DSM-IV criteria for depressive disorders in 2015. Using 1:1:1 matching by gender, age, and residence, 825 non -afflicted individuals were selected as high -risk controls, and 825 screening -negative individuals became low -risk controls. A follow-up study in 2020 involved 1848 participants. Survey tools included a general information questionnaire, General Health Questionnaire -12 (GHQ -12), SCID-I/P, Global Pain Scale (GPS), Quality of Life Questionnaire (QLQ), PSQI, MoCA, and clinical data questionnaire. Results: GPS scores in the current depressive group were higher than in non -current depressive group ( Z = 14.36 , P < 0.01). GPS scores in study group exceeded those in high -risk and low -risk control groups ( H = 93.71 , P < 0.01). GPS scores in non -remission group were higher than in the remission group ( Z = 8.90 , P < 0.01). Regression analysis revealed positive correlations between GPS scores and physical illnesses, current depression, incumbency, GHQ -12 total score, and PSQI total score. Negative correlations were observed with QLQ total score and MoCA total score. Limitations: The study could not assess pain during the 2015 survey, limiting controlled pain analysis before and after five years. Conclusion: Depression sufferers may experience prolonged heightened pain, potentially relieved when depression subsides. Individual pain is influenced by depression, physical illnesses, sleep quality, quality of life, cognitive function, gender, residence, and occupation.

BACKGROUND:The timings of reproductive life events have been examined to be associated with various psychiatric disorders. However, studies have not considered the causal pathways from reproductive behaviors to different psychiatric disorders. This study aimed to investigate the nature of the relationships between five reproductive behaviors and twelve psychiatric disorders. METHODS:Firstly, we calculated genetic correlations between reproductive factors and psychiatric disorders. Then two-sample Mendelian randomization (MR) was conducted to estimate the causal associations among five reproductive behaviors, and these reproductive behaviors on twelve psychiatric disorders, using genome-wide association study (GWAS) summary data from genetic consortia. Multivariable MR was then applied to evaluate the direct effect of reproductive behaviors on these psychiatric disorders whilst accounting for other reproductive factors at different life periods. RESULTS:Univariable MR analyses provide evidence that age at menarche, age at first sexual intercourse and age at first birth have effects on one (depression), seven (anxiety disorder, ADHD, bipolar disorder, bipolar disorder II, depression, PTSD and schizophrenia) and three psychiatric disorders (ADHD, depression and PTSD) (based on p<7.14×10-4), respectively. However, after performing multivariable MR, only age at first sexual intercourse has direct effects on five psychiatric disorders (Depression, Attention deficit or hyperactivity disorder, Bipolar disorder, Posttraumatic stress disorder and schizophrenia) when accounting for other reproductive behaviors with significant effects in univariable analyses. CONCLUSION:Our findings suggest that reproductive behaviors predominantly exert their detrimental effects on psychiatric disorders and age at first sexual intercourse has direct effects on psychiatric disorders.

Abstract Objective To systematically evaluate the effect of Acceptance and Commitment Therapy (ACT) on depressive disorders. Methods The electronic databases of Web of Science Core Collection, Pubmed, EMBASE, Cochrane Library, PsycInfo, CNKI, Wanfang and Weipu were used to select relevant publications. Screening, data extraction, and quality assessment were undertaken following PRISMA guidelines for preferred reporting of systematic reviews and meta-analysis. RevMan5.4 was used for meta-analysis. Results 11 studies with a total of 962 patients were included. Random-effects model analysis showed that ACT could effectively reduce the level of depressive symptoms in patients with depressive disorders (SMD = − 1.05, 95% CI: − 1.43–− 0.66, P < 0.00001), improve psychological flexibility (MD = 4.84, 95% CI: 2.70–6.97, P < 0.00001), and have good maintenance effect (SMD = − 0.70, 95% CI: − 1.15–− 0.25, P = 0.002). All differences were statistically significant. Conclusions ACT not only improves depressive symptoms and psychological flexibility, but also has a good maintenance effect, and it is particularly effective in Chinese patients. Large randomized controlled trials are needed to validate the findings from this meta-analysis.

Background: Growing evidence indicates high comorbid anxiety and depression in patients with asthma. How-ever, the mechanisms underlying this comorbid condition remain unclear. The aim of this study was to inves-tigate the role of inflammation in comorbid anxiety and depression in three asthma patient cohorts of the Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED) project.Methods: U-BIOPRED was conducted by a European Union consortium of 16 academic institutions in 11 European countries. A subset dataset from subjects with valid anxiety and depression measures and a large blood biomarker dataset were analysed, including 198 non-smoking patients with severe asthma (SAn), 65 smoking patients with severe asthma (SAs), 61 non-smoking patients with mild-to-moderate asthma (MMA), and 20 healthy non-smokers (HC). The Hospital Anxiety and Depression Scale was used to measure anxiety and depression and a series of inflammatory markers were analysed by the SomaScan v3 platform (SomaLogic, Boulder, Colo). ANOVA and the Kruskal-Wallis test were used for multiple-group comparisons as appropriate.Results: There were significant group effects on anxiety and depression among the four cohort groups (p < 0.05). Anxiety and depression of SAn and SAs groups were significantly higher than that of MMA and HC groups (p < 0.05. There were significant differences in serum IL6, MCP1, CCL18, CCL17, IL8, and Eotaxin among the four groups (p < 0.05). Depression was significantly associated with IL6, MCP1, CCL18 level, and CCL17; whereas anxiety was associated with CCL17 only (p < 0.05).Conclusions: The current study suggests that severe asthma patients are associated with higher levels of anxiety and depression, and inflammatory responses may underlie this comorbid condition.

目的 探讨初中生非自杀性自伤(NSSI)、抑郁情况,分析抑郁在行为抑制/激活系统(BIS/BAS)与NSSI之间的中介作用.方法 采用整群抽样法,于2022年6月选取山东省济宁市泗水县3所中学2900名初中生为研究对象,采用青少年自伤行为问卷、BIS/BAS量表和抑郁自评量表(SDS)进行问卷调查.采用Pearson相关分析各变量之间的相关性.采用SPSS Amos 24.0软件构建结构方程模型并进行中介效应检验.本研究共发放问卷2900份,回收有效问卷2429份,有效回收率为83.76％.结果 2429名初中生的NSSI年发生率为37.55％(912/2429),抑郁发生率为32.73％(795/2429).根据是否有过NSSI行为分为有NSSI组(n=912)和无NSSI组(n=1517).有NSSI组初中生的青少年自伤行为问卷得分为(33.01±21.24)分.有NSSI组初中生的BIS、BAS-愉悦追求、SDS得分分别为(11.08±2.93)、(7.15±2.58)、(53.17±10.67)分,高于无NSSI组的(10.16±3.15)、(6.52±2.55)、(43.16±9.77)分,差异有统计学意义(t=-7.312、-5.838、-23.098;P<0.001);有NSSI组初中生的BAS-奖赏反应得分为(11.64±2.53)分,低于无NSSI组的(12.16±2.24)分,差异有统计学意义(t=5.084,P<0.001).相关分析显示,有NSSI初中生的抑郁程度与NSSI严重程度、BIS敏感性、BAS-愉悦追求敏感性呈正相关(r=0.484、0.184、0.128;P<0.01);BAS-奖赏反应敏感性与NSSI严重程度、抑郁程度呈负相关(r=-0.203、-0.239;P<0.01).回归分析显示,抑郁对NSSI有正向影响(β=0.461,P<0.001),而BAS-奖赏反应对NSSI有负向影响(β=-0.093,P<0.01).结构方程模型结果显示,抑郁在BIS、BAS-愉悦追求与NSSI之间起完全中介作用,完全中介效应分别为0.121和0.104,占总效应的86.4％、72.7％;在BAS-奖赏反应与NSSI之间起部分中介作用,部分中介效应为-0.199,占总效应的58.2％.结论 初中生NSSI发生率较高,抑郁在BIS和BAS-愉悦追求与NSSI间起完全中介作用,在BAS-奖赏反应与NSSI之间起部分中介作用.

Abstract Objectives Internet addiction is gaining attention because of the physical, psychological and social damage it can cause to individuals. There has been little systematic exploration of the relationship between Internet addiction and the influence of the family environment among junior high school students in China. Methods A whole-group sample of three county-level junior high schools in China was used to investigate the relationship between adolescents' Internet addictive behaviour and their family environment using the General Situation Questionnaire, Family Environment Scale-Chinese version, and the Internet Addiction Test (IAT). Results The prevalence of Internet addiction among junior high school students in China is 33.7%, among which 76.0% of junior high school students are mildly addicted to the Internet. The prevalence of Internet addiction among female students is 32.4%, and 35.0% among male students. the prevalence of Internet addiction among junior high school first year, junior high school second year and junior high school third year is 27.3%, 35.5% and 38%, respectively. The prevalence of Internet addiction among urban junior high school students is 27.5%, and the prevalence of Internet addiction among rural junior high school students is 34.5%. In terms of family environment, cohesion, expressiveness, independence, achievement, intellectual-cultural, active-recreational, moral-religious, organization, and control are negatively associated with Internet, family conflict is positively associated with Internet addiction (p < 0.01). The results of multiple stepwise regression analysis showed that seniority and prominent family conflict are risk factors for Internet addiction (P < 0.01), while female, good family expressiveness and organization, family intellectual-cultural, active-recreational and family control are prominent as protective factors for Internet addiction (P < 0.05). Conclusion Chinese junior high school students have a high prevalence of Internet addictive behaviours, with the highest proportion of mild Internet addictive behaviours. Males and senior students are more likely to develop Internet addictive behaviours. Family factors have a significant impact on the occurrence of Internet addiction, and interventions in the family environment of adolescents can effectively reduce the prevalence of Internet addictive behaviours.

Background Non-suicidal self-injury (NSSI) is more common in adolescents and its occurrence may be influenced by personality traits. Children and adolescents are a high-risk group for NSSI. Although there are some studies on the prevalence of NSSI, however, there are fewer studies on the factors associated with the severity of NSSI and the specific causes of the influence of NSSI and personality traits. Methods Participants of this study were junior high school students enrolled in three different schools of a Chinese province. NSSI was evaluated using the Adolescents Self-Harm Scale and their personality traits were assessed using the Neuroticism Extraversion Openness Five-factor Inventory (NEO-FFI). Results 2376 junior high school students participated, and the annual incidence of NSSI was 37.1% (n=881). The mean age of the NSSI-detected individuals was 13.61 years (SD=1.017). Out of total number of detections, 56.6% (n=499) were female and 67.4% (n=594) were individuals who self-injured using multiple means. Hair pulling, scratching the skin, and whacking harder objects with the hand were the most common modes of NSSI, with incidences of 51.0%, 43.0%, and 42.8% respectively in the NSSI-detected population. There was a negative association between grade and NSSI severity (p < 0.05), and NSSI was more severe in females. The scores in the Neuroticism dimension were higher in the group with NSSI than in the group without NSSI, while the scores in the extraversion, openness, agreeableness and conscientiousness dimensions were lower than in the group without NSSI (p < 0.01). Neuroticism and openness were significantly positively correlated with NSSI severity, and extraversion, agreeableness, conscientiousness were significantly negatively correlated with NSSI severity (p < 0.01). Conclusion The severity of NSSI was relatively higher in lower grades among junior grades and females, and the number of self-injury using multiple means was significantly higher; hair pulling, skin scratching and whacking harder objects with hands were the most common NSSI modalities. Among the personality traits, for the incidence of NSSI, high neuroticism was a risk factor, and high extraversion, openness, agreeableness, and conscientiousness were protective factors. For the severity of NSSI, high neuroticism and high openness were risk factors, and high extraversion, high agreeableness, and high conscientiousness were protective factors.

Background: Despite the enormous changes observed in China since entering the 21st century, little is known about changes in sleep quality among older adults. Aims: The purpose of this study is to explore the changes, features, and influence factors of sleep quality among the elderly in a ten-year period, providing evidence for sleep-quality enhancement. Methods: The data were obtained from the data of epidemiological sampling surveys on mental disorders in Shandong province in 2004 and 2015. A total of 4451 subjects (aged ≥ 60 years) in 2004 and 10,894 subjects (aged ≥ 60 years) in 2015 were selected by the multistage stratified sampling method. The demographic information and Pittsburgh Sleep Quality Index (PSQI) were collected. Results: The adjusted 1-month prevalence of poor sleep in 2015 was 22.5% (95% CI:21.7–23.3), which is lower than that in 2004 (24.8%) (95% CI:23.5–26.0, p = 0.002). The total score of the PSQI in 2015 (4.74 ± 3.96) was lower than that in 2004 (4.97 ± 4.18, p = 0.002). In 2015, a binary multi-factor logistic and stepwise regression analysis showed that being female, living in a rural area, living alone, being older, spending less years in school, and being jobless/unemployed made the participants more likely to develop poor sleep (p < 0.05, p < 0.01). Conclusions: In 2015, the overall sleep quality of the elderly (aged ≥ 60) in Shandong province was significantly improved compared to 2004. After more than 10 years, the characteristics of the elderly with sleep disturbances in Shandong province has changed. Therefore, more attention should be paid to gender, location of residence (rural or urban), living arrangement, age, education, occupation, and other factors to improve the sleep quality of the elderly.

BACKGROUND:Depression is characterized by debilitating symptoms and high recurrence rates, and there are relatively few large-scale epidemiological surveys of depressive disorders conducted in Shandong since 2005. Data from the largest Epidemiological Survey of Mental Disorders conducted in 2015 in Shandong were collected to investigate the prevalence of depressive disorders and associated demographic characteristics in general adult population.METHODS:A multi-stage stratified cluster sampling method was adopted to select residents and a two-stage screening and assessment process was used to define the prevalence and characteristics of depressive disorders. Respondents were initially screened using the General Health Questionnaire followed by a structured clinical interview using the DSM-IV criteria.RESULTS:Among 27,489 respondents who completed the survey, 1277 respondents met the diagnostic criteria for depressive disorders. The adjusted prevalence in the last month was 4.86%, among which the prevalence of major depressive disorder, dysthymia, and unspecified depressive disorder were 2.32%, 1.78%, and 0.75%, respectively. 40.35% of depression patients had moderate or severe functional impairment and only 10.65% of patients had visited a psychiatric service. Univariate and multivariate analyses revealed that age, gender, occupation, education, marital status, and urban/rural living were associated with the prevalence.LIMITATIONS:The key limitation is that this is a cross-sectional survey therefore cannot draw any causal relationship between risk factors and disease progression.CONCLUSIONS:Findings from this largest epidemiological study reveal current prevalence of depressive disorders and associated demographic factors and offers opportunities for policy makers and health-care professionals to improve mental health provision in Shandong.

目的:了解山东省精神障碍患者的生命质量状况,分析其相关因素.方法:2015年,采用多阶段分层整群随机抽样在山东省开展第四次精神障碍流行病学调查.筛选符合精神障碍诊断与统计手册第4版诊断标准的精神障碍患者作为研究对象.采用一般情况调查表、匹兹堡睡眠质量指数量表、简易应对方式问卷、功能大体评定量表、生命质量量表进行调查.结果:农村居民(β=-0.96,P＜0.01)、女性(β=-1.92,P＜0.001)、未婚(β=-2.72,P＜0.01)、农民/渔民(β=-0.94,P＜0.05)、无业或失业(0=-1.93,P＜0.01)患者生命质量得分更低,躯体健康状况(β=-5.59,P＜0.001)和心理健康状况(β=-4.19,P＜0.001)越差、匹兹堡睡眠质量指数(β=-0.49,P＜0.001)越高,患者生命质量得分越低;积极应对(β=1.65,P＜0.001)和功能大体评定量表(β=0.12,P＜0.001)得分越高,患者生命质量得分越高.结论:精神障碍患者生命质量较差,应重点关注农村居民、女性、未婚、农民或渔民、无业或失业、躯体或心理健康状况差、睡眠质量差、功能受损重,较少采取积极应对方式的患者,提高其生命质量.

目的 探讨山东省抑郁障碍患者应对方式的特点及影响因素.方法 研究组为2015年山东省精神障碍流行病学调查中诊断出的且量表完整的1174例抑郁障碍患者,对照组为按照与研究组同性别、同年龄组、同村居1:1配对原则,自调查对象中抽取的筛查阴性者.研究工具包括自制的一般资料调查表、一般健康问卷(GHQ-12)及增加的风险评估问题、DSM-Ⅳ轴Ⅰ障碍用临床定式检查(SCID-I/P)、功能大体评定量表(GAF)及简易应对方式问卷(SCSQ).结果 研究组SCSQ积极应对评分低于对照组,消极应对评分高于对照组(P<0.01).未特定抑郁障碍的积极应对评分高于其他两个亚型(P<0.01).研究组中不同职业、医疗来源、年龄、受教育程度、GAF评分的积极应对评分比较差异有统计学意义(P<0.05),研究组中仅不同居住方式的消极应对评分比较差异存在统计学意义(P<0.01).相关性分析结果显示,受教育程度、GAF评分与积极应对评分均呈正相关(P<0.01),年龄与积极应对评分呈负相关(P<0.01).回归分析结果显示,医保/商业保险、受教育程度、GAF评分能预测积极应对评分的4.8％.结论 抑郁障碍患者较一般人群多采取消极应对方式,较少采取积极应对方式;恶劣心境障碍患者采取积极应对方式的能力更差;无医疗来源、较低的受教育程度、严重的社会功能受损是抑郁障碍患者积极应对能力的危险因素.

Background Adolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet. Methods For middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI. Results A total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% ( n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% ( N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated ( P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI. Conclusion The prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.

目的 探讨山东省某三所县级中学初中生非自杀性自伤行为(NSSI)的发生率、严重程度与家庭环境的关系.方法 对山东省某县3所中学的2397名在校中学生,使用一般情况调查表、青少年自我伤害问卷和家庭环境量表中文版(FES-CV)调查NSSI的发生情况及该行为与家庭环境等因素的关系.结果 山东省某三所县级中学初中生NSSI的发生率为37.1％,不同性别、年级、成长环境NSSI发生率比较差异均有统计学意义(P<0.01).NSSI最常见的方式为拔头发,其次为用玻璃、小刀等划伤皮肤等,使用2种及以上自我伤害方式者占NSSI群体的68.2％,而使用单一手段进行NSSI的群体占31.8％.有NSSI初中生FES-CV亲密度、情感表达、独立性、成功性、知识性、娱乐性、道德宗教观、组织性评分均低于无NSSI初中生(P<0.01),矛盾性评分高于无NSSI初中生(P<0.01).FES-CV亲密度、情感表达、组织性均与NSSI严重程度呈负相关(P<0.01),家庭矛盾性与NSSI严重程度呈正相关(P<0.01).多元逐步回归分析结果示,女性、家庭文化性突出是NSSI程度严重的危险性因素(P<0.05),而家庭亲密度高、情感表达良好是NSSI程度严重的保护性因素(P<0.01).结论 山东省某三所县级中学初中生NSSI的发生率较高,且女生发生率高于男生,农村发生率高于城市.家庭因素对NSSI的发生及严重程度具有显著影响.

Background: Although the 2000s observed enormous changes in China, little is known about the variation in the prevalence of mental disorders. The study compared the prevalence in a Chinese population between 2004 and 2015. Methods: Multistage stratified random sampling methods were used to identify primary sampling sites for crosssectional surveys in 2004 and 2015 in Shandong, China. In 2004 and 2015, 22,718 and 28,194 adults, respectively, completed an expanded version of the General Health Questionnaire, then 5,402 and 9,420 adults, respectively, were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual-IV axis I disorders. Results: The adjusted 1-month prevalence of any mental disorders was 18 center dot 7% (95% CI: 16 center dot 7-20 center dot 8) and 17 center dot 1% (95% CI:15 center dot 9-18 center dot 4) in 2004 and 2015, respectively. However, the prevalence of major depressive disorders increased from 1 center dot 5% (95% CI: 1 center dot 2-1 center dot 8) in 2004 to 2 center dot 3% (95% CI: 1 center dot 9-2 center dot 8) in 2015; meanwhile the prevalence of alcohol abuse disorders were becoming more common among men and urban residents. Although mood and anxiety disorders were more prevalent in women, a much more prevalent alcohol abuse disorders for men contributed to a higher overall prevalence among men than among women. Compared to that in urban residents, the overall prevalence in rural residents declined more, and it was lower in 2015 than in 2004. Limitations: The results may not apply to the population from other regions. Conclusions: Despite of the stable overall prevalence, mental disorders beyond psychotic disorders should be focused on, especially alcohol abuse and major depressive disorders.

Background Rapid urbanization, academic pressures, and developmental life transition stressors contribute to mental health stress for postsecondary students in China. Effective prevention, early identification, and timely intervention are challenged by stigma, a lack of mental health literacy, and inadequate mental health resources. Objective Our implementation science (IS) research project is aimed at evaluating the use of an evidence-informed mental health promotion intervention named Acceptance and Commitment to Empowerment – Linking Youth and ‘Xin’ (hearts) (ACE-LYNX) to promote university student mental health in Jinan, China. Methods We will engage and collaborate with Shandong Mental Health Center, the provincial mental health center, and six local universities in different regions of Jinan. The ACE-LYNX intervention aims to reduce social stigma against mental illness, enhance mental health literacy, and improve access to quality mental health care by increasing interdisciplinary collaboration and forming a mental health network. It is based on two evidence-based approaches, Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP), and it will be delivered through online learning and in-person group training. The project will train 90 interdisciplinary professionals using the model. They will in turn train 15 professionals and 20 students at each university. The project will adopt the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework, which provides a structure to examine the process and outcomes of implementation using mixed methods comprising quantitative and qualitative approaches along five dimensions: reach, efficacy, adoption, implementation, and maintenance. Results Over the course of the project, 720 champions will be directly trained. They will contribute to developing a formal and informal mental health network, strengthened by student-led mental health initiatives and professional-led initiatives to promote collaborative care and facilitated care pathways. We anticipate that our project will reach out to 11,000 to 18,000 students. Conclusions This IS protocol will outline our unique intervention model and key steps to contextualize, implement, and evaluate community-based mental health intervention. International Registered Report Identifier (IRRID) PRR1-10.2196/25592

Objective:This study aims to investigate the prevalence and distribution characteristics of mental disorders among people aged 18 and above in Shandong Province.Methods:In 2015, an epidemiological survey was carried out to investigate the patterns of mental disorders in 49 counties of Shandong Province. A total of 28 000 individuals aged 18 years or older were selected using the multistage stratified cluster sampling method. All these participants were classified as at a high or low risk of mental disorders according to the assessment results of the revised version of the General Health Questionnaire (GHQ). The diagnosis of mental disorders was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual, Forth edition (DSM-Ⅳ) axis I or MMSE. All participants at high risk of mental disorders were evaluated using DSM-Ⅳ or MMSE to confirm the psychiatric diagnoses, while 10% of participants at low risk of mental disorders were randomly selected to be evaluated. The prevalence and its 95% confidence interval of mental disorders were adjusted according to study design and sociodemographic characteristics of the sample. The between-group differences of prevalence were compared using chi-square tests or Fisher′s exact tests as appropriately.Results:A total of 27 489 individuals completed survey. The adjusted prevalence of any mental disorder was 17.46% (95 %CI 17.02%-17.89%). The five most prevalent mental disorder spectrums were substance use disorders (5.29%), mood disorders (4.47%), anxiety disorders (4.46%), intellectual and mental disorders due to physical or substance (1.91%), and psychotic disorders (1.12%). The most common mental disorders were alcohol use disorder (5.27%) and major depressive disorder (2.14%). The prevalence of mental disorders in men was higher than that in women (23.37% vs. 13.89%; χ 2=408.91, P<0.01). There was no significant difference in the prevalence of mental disorders between rural residents and urban residents (17.69% vs. 17.20%; χ2=1.05, P=0.305). Of participants with mental disorders, 26.12% (1 047/4 008) had moderate to severe functional impairment and 10.98% (428/3 898) have sought professional help. Conclusion:The prevalence of mental disorders among people aged 18 and above in Shandong Province is basically consistent with the results of similar domestic studies. The prevalence of mental disorder was higher in men than in women and was not differ in participants living in urban and rural areas. Alcohol use disorder, major depressive disorder, non-specific anxiety disorder and non-specific depressive disorder are most common mental disorders.